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- 1What are some of the risks or problems that occur with poor patient discharge communication?- Patients and parents who are not very dose/prescription literate might overuse or underuse the medications, thus potentially risking their health or their child's.
-Patients not comprehending the severity of their condition, overlooking threatening side effects. Therefore, risking their health and don't visit the ED
-Patients could miss out on follow-ups.
-Not being able to remember or recall the discharging instructions they were given because they didn't understand.
-Feeling dissatisfied with the care given.
-Not being able to improve their health condition because they didn't know how to keep up with their at-home care. - 2What are some of the interventions considered in the review article to help improve discharge communications?- Translating the instructions in the patient's language, as well as making them easy to understand and follow.
-Make use of visual cues, videos or electronics
-Make comprehension checks, have the patient read/teach back the instructions.
-Use patient reminders
-Implementing dose demonstration.
-Assistance with follow-up appointments
-Connect the patient to care programs for chronic illness
-Tailor the aftercare raking into account the learning needs or limitations of patient - 370 % of these are related to communication error. In other words is not a lack of technical skill,but of __________bad communication
- 4Sentinel event(never events) is defined as a major problem that you would hope would never happen that leads to investigation and the creation of a design/structure to avoid this from ever happening again.
- 5Hospitals is where most errors occurwhere most of the hardest things happen like surgery, giving birth etc.
- 6What you should always tell patients when discharging themWhat they have, what to expect,know what type of medication they will be on if any
- 7Discharge instruction solutions ( do it well)Use an interpreter if necessary/ printout the instructions in their language
● Confirming the condition
● Safe loop with discharging ( have them repeat things back to you to check their comprehension)
● Write in a 6 grade level( this is the reading level of the majority of the population.)
● Use printed instructions
● Ask if they have any questions
● Avoid jargon
● Recording discharge instructions
● Explain which side effects
● Short and to the point ‘instructions from the doctor
● Follow up call and text messages
● Trying to include family member or a friend so they can listen too
● Check comprehension with questions
● Use pictures demonstrations - 8things to avoid- Anchoring to a bias, ambiguous moment of transfer,the area is busy and loud, not being clear and concise,excessive use of technology,interruptions, and trying to rush, these will lead to bad communication exchanges.
- 9How to do sign outs1. Finish up your duties before your leave (don't do things halfway)
2. Relay the info inside the patient's room
3. Have a standardised procedure like a fill out sheet /sign out tool /checklist.
4. Have shifts overlap so that you don't rush.
5. Not rushing and avoid interruptions
6. Reducing the number of handoffs by finishing up when possible - 10How can we prevent medication errorsA. Write it out. This prevents errors and avoids confusing medications that sound alike
B. No verbal orders unless is an emergency again WRITE IT!
C. Limit use of abbreviations
D. Weight should ALWAYS be in kg (kilograms)
E. Use allergy bands when necessary to avoid contraindications.
F. Prepackaging med by dosing need, this is handy with children doses as they differ by age and weight.
G. Use smart checks
H. Integrate pharmacists.bar coding
I. Tall man lettering - 11how to handle delay-Validating their frustrations and thanking them for waiting
- 12Root cause analysis-is when you try to understand the root of the error and try to find ways to prevent it from happening again.
- 13How to give a good apologyAcknowledge the hurt you've caused
- Recognize the consequences
- Ask the other person if they have anything they want to add ( take the heat)
- Promise to be dedicated to not repeating the error
- Say ” I'm sorry “ THIS SHOULD BE THE LAST THING YOU DO. - 14What makes medical error so personally difficult?It affects the patient, and it also affects the clinicians because the expectations are perfection in medical care. There is fear of recurrence,litigation,loss of reputation, security is threatened and fear of losing license and reporting issues, and.confidence is shaken.There are feelings of embarrassment and shame..
● The provider will then need support - 15What a provider wants after they make a mistakEmotional support, familiarity with the process of what is going to happen next, the need to talk it out and defrief.Additionally, maybe time off and counseling
- 16How the hospitals are trying to cope with it (help clinicians)● Hospitals training staff to report and investigate error
● Communicating with patients and families after error
● Formal efforts to reduce errors
● Creating effective,inclusive peer support programs - 17Criminal vs civilIn the criminal system, it is the government that brings a case against a defendant, and in civil court, citizens can bring lawsuits against one another. ... For instance, prison is a possibility in certain criminal cases, whereas civil cases do not punish the accused with incarceration
- 18Plaintiffperson making the allegation
- 19Defendantperson who is being sued, is normally the doctor
- 20Settled vs trialTrials often expose the financial and personal vulnerabilities of those involved. Settlement provides a quicker solution and alternative to an ongoing court battle.
- 214 components in order for malpractice to occurDuty to act
- Acted below the standard of care what the average acceptable standard of care would be)
- Harm occurred
- Prove that the harm was caused by acting or not acting by the breach of care standard. - 22Being sued - what happens next ?Claims letter
● Complaint letter
● Interrogatories
● Deposition
● Deposition
● Trial
● Penalty phase
● Reporting implications - 23What does “a shared mental model” mean?A shared mental model means an understanding of the situation, task, and the resources in a coordinated way to centralize information, establish structure and stabilize emotions.
- 24“mitigated speech”mitigated speech, meaning that they often de-emphasized and sugarcoated things. This led to the crashes. It was not until they acknowledge this as a communication proble
- 25resuscitate by voiceResuscitate by voice means to communicate and address the team during critical times or difficult situations rather than being silent. It promotes speaking and for the team members to state their intentions or what they are doing as they work. This is important because it keeps everyone informed and aware. It also serves as a double-check to make sure there are no contraindications. Therefore, reducing the risk for errors.
- 26What are 2 practical strategies to enhance short term medical communicationTwo practical strategies to enhance short term medical communication is to speak up and focus on what's right for the patient rather than on who's right. This means adjusting the way you communicate by being assertive and taking control when required.
- 27“below 10,000 feetIt means that pilots shouldn’t speak, or to avoid nonessential conversations if they are under 10,000 ft in the air. As they should devote their focus to their role operating the plane to essentially stay aware and avoid problems/accidents. Likewise, this rule applies to physicians. in a medical setting, this can come in handy when performing surgery, especially in sensitive areas like the eyes
- 28how to avoid burn outsleep well take vacations exercise support group debreather techniques
- 29signs of burn outloss of interest fatigue stress unhappiness snappy less invested cynical apathy anxiety depression irritation, sleeping problems, turn to addiction,isolation,divorce.
- 30causes for burn outpaperwork lawsuits expectations from patients, no time to get to know patients, long hours of work, dealing with difficult cases, understaffed
- 31criticize in ___ and praise in ____private, public
- 32working in a team must do during critical situationshave a leader and know your role,use close loop communication, follow safety protocols, be confident avoid confusing language, stay aware of time and picture.
- 33breaking bad newsinvolve social worker. be prepared, attention to detail.
- 34HIPAAa federal law that deals with patients privacy and information handling
- 35people have the right to their information and regulation agencies.when you are required to give out information
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- FlashCards sobre Sem título, criado por Gabriela Feliciano em 18-11-2019.
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- Gabriela Feliciano
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